Is the version of the USMLE for IMGs harder than for AMGs?

Share if you like this post
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  

Along with “the USMLE is getting harder every year” claim, these 2 are probably the longest running and most persistent myth in various USMLE forums since 2005. The examination for IMGs (International Medical Graduates) and AMGs come from the same pool of questions and are more or less the same. The only difference being that only AMG performance is use to calculate the passing score for the examination. The passing score is set at that score where 90% of AMGs will pass the examination. Hence, every time the passing rate for AMG starts creeping up, the USMLE raises the passing grade. The performance of IMGs are never considered in the process.

The usual basis for this observation is that while over 90% of AMGs pass the USMLE Step 1, only 65% of IMGs pass the USMLE Step 1 on their first take. However the real reason for this occurrence is manifold.

First, all medical schools train their students to pass their own medical boards. This is because board passing rate is an important criteria for these schools to remain open. The US is no different from other countries in this regard. And unless your country’s medical school is specifically geared to graduating medical students for practicing in the US, you will tend to do better in your own country’s medical board exam. AMGs will probably have a lower passing rate as a whole when attempting to take another country’s medical board.

Second, the disease prevalence in different countries are of course quite different and your medical school will naturally focus on the most prevalent diseases in your area which may be quite different from the US. For example, Sickle Cell is a disease that primarily strikes the Black population and if you come from European or Asian country you may not have ever seen a single case. Cystic Fibrosis is a predominantly Caucasian disease and will not be well studied in Asia or Africa. Dengue might be prevalent in Asia but is quite rare in the US while the opposite is true of Histoplasma. Therefore, AMGs will have an advantage in that the information they have mastered is the one actually being tested in the USMLE.

Thirdly, there is a cultural bias which, depending on how different your cultural values are can impact your scores. I am of course talking about Behavioral Science in step 1 and Ethics in Step 2 CK and Step 3. Again, this can impact an IMGs score tremendously as Behavioral Science can cover up to 10% of your step 1 score.

And so, although both IMGs and AMGs are taking the same set of examinations, IMGs will find the exam harder than most AMGs.

Related Posts:

Share
Like This Page!
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  

5 thoughts on “Is the version of the USMLE for IMGs harder than for AMGs?

  • Pingback:Is the USMLE getting tougher every year? | askdoc-usmle

  • February 5, 2010 at 12:27 am
    Permalink

    I totally agree with your post. Its not that the exam is harder but the topics tested are somewhat different thatn the ones IMGs might have to focus on in their own med schools. I am An IMG and i took the step 1 a month ago. I had a mammoth task trying to get TB out of my system as the top differentail for everything..still managed it 🙂
    step 2 CK in two months… fingers crossed for this one too.
    I am not listening to all the wierdos telling me not to take it in my home country but with my CS in June.

  • October 22, 2010 at 4:54 pm
    Permalink

    Now I know the version is the same for both AMG’s and IMG’s, but what about the myth that says that is harder to get a higher grade if you take the exam on june-july or in december because your score is compared to the scores of the AMG’s that take the USMLE on those months (which are most of them), what do you think about that?

  • November 7, 2010 at 8:30 am
    Permalink

    Hi Luis,
    The reason USMLE takes great pains to test questions for difficulty level before scoring them (hence experimental questions) and takes the time to normalized the scores is because they need the scores of examinees to be comparable even if they took the exam years apart. That is part of the mandate of the USMLE in formulating this examination. The only way to do that is to use the scores of examinees that took the examination over several years to come up with the normalized scores. Therefore your scores are always compared to thousands of examinees (AMG) only that took the exam years before and not on the same year you took it. If they do it the way you described, then the scores of examinees that took the exam in different years will not be comparable.

    Askdoc

  • December 1, 2010 at 5:39 am
    Permalink

    Hi Luis,

    The USMLE scores is set up so you can compare them even when taken years apart. This comparability is important when programs are deciding which candidates to consider as not all candidates who apply at the same time took the exam time or even the same year. Doing it the way you describe, using the basis for scoring only the scores of each batch will make it impossible to compare scores taken during different years. Therefore, scores are always normed over several years worth of examinees and not any specific year or time. Hope that answers your question.

    Askdoc

Leave a Reply

Your email address will not be published. Required fields are marked *